Liu Haoming, Santanello Abbey, Jimenez Mercy, Kumthekar Narendra
Medicine, Touro College of Osteopathic Medicine, Middletown, USA.
Medicine, Touro College of Osteopathic Medicine, New York City, USA.
Cureus. 2022 Apr 19;14(4):e24272. doi: 10.7759/cureus.24272. eCollection 2022 Apr.
Jejunal gastrointestinal stromal tumor (GIST) is a rare cause of recurrent gastrointestinal bleeding (GIB). Early diagnosis for patients with jejunal GIST is often challenging, which can lead to delays in treatment. We present a case of a 32-year-old male patient with persistent abdominal pain and hematemesis despite treatment for gastroesophageal reflux disease (GERD). Upon initial ER visit, CT result was consistent with intra-abdominal abscess and the patient underwent interventional radiology (IR) drainage. On a second ER visit three weeks later, CT showed a suspicious lesion in the small bowel. The patient underwent exploratory laparoscopy which revealed a mass in the jejunum. The lesion was resected successfully and pathology report confirmed the diagnosis of GIST with positive immunohistochemistry marker cluster of differentiation (CD)117. The patient was discharged with no complications post-operatively. In conclusion, recurrent GIB and unusual imaging findings should raise clinical suspicion for alternative causes for GIB, including tumors such as GIST.
空肠胃肠道间质瘤(GIST)是复发性胃肠道出血(GIB)的罕见病因。空肠胃肠道间质瘤患者的早期诊断往往具有挑战性,可能导致治疗延误。我们报告一例32岁男性患者,尽管接受了胃食管反流病(GERD)治疗,但仍持续腹痛和呕血。初次急诊就诊时,CT结果与腹腔脓肿一致,患者接受了介入放射学(IR)引流。三周后第二次急诊就诊时,CT显示小肠有可疑病变。患者接受了 exploratory laparoscopy,发现空肠有肿块。病变成功切除,病理报告通过免疫组化标记分化簇(CD)117阳性确诊为胃肠道间质瘤。患者术后无并发症出院。总之,复发性胃肠道出血和异常的影像学表现应引起临床对胃肠道出血其他病因的怀疑,包括胃肠道间质瘤等肿瘤。